Health Minister Terry Lake has been fielding questions lately about curtailments and extra costs for patients.
He鈥檇 better get used to it.
Some of the changes in question are flowing from budgets given to the various health authorities that are a lot more generous this year than they will be in the next two years.
鈥淏ending the curve鈥� of health care costs 鈥� meaning slowing the never-ending rate of increase 鈥� involves holding the frontline providers to some pretty measly increases in the next two years.
The Fraser Health Authority, for example, has prompted a fuss over its wheelchair fees for residential-care patients. That idea is coming in a year when they are expecting a 5.6 per cent increase in their operating budget.
But next year they are expecting a 4.9 per cent increase and the year after a 2.5 per cent increase.
If they鈥檙e talking about charging for wheelchairs with a 5.6 per cent hike, it makes you wonder what鈥檚 coming in two years, when they have to get by with a 2.5 per cent lift.
Similarly, the 91原创 Island Health Authority has curtailed some laboratory services at a time when they鈥檙e dealing with a 5.2 per cent increase. Next year, the budget is slated to be 1.8 per cent higher, and 2.2 per cent higher the year after.
The Opposition on Wednesday focused on the $25 monthly wheelchair charge, based on a freedom-of-information request by 91原创 reporter Bob Mackin. It produced a briefing note suggesting it was the Ministry of Health鈥檚 idea, as much as the health authority鈥檚.
They had a proposal in the works, but the note says the ministry requested them to 鈥渋mplement wheelchair maintenance fees鈥� to align with a similar proposal elsewhere.
Lake said the government鈥檚 main idea was to introduce some consistency to the current patchwork system, where some facilities charge and some don鈥檛. And there鈥檚 no threat to low-income residents, as fees will be waived if they can鈥檛 afford them.
The charge has always been allowed under the regulations governing assisted-living facilities, but some authorities don鈥檛 bother applying it.
The note shows the idea was marked on 17 different criteria and scored a -13, which doesn鈥檛 exactly qualify it as a 鈥渟troke of genius.鈥�
Nonetheless, it could bring in $300,000 in the next two years.
The previous day, Lake was defending the lab-services cuts by the 91原创 Island Health Authority.
A few smaller labs are cutting hours because they were only handling a handful of people a day.
Lake had an observation when asked about the reduction.
鈥淲hen services are added, no one scrums me to ask: 鈥榃hy are you adding all those services?鈥� Sometimes when demand goes down, services are reduced. That鈥檚 the responsible thing to do.鈥�
Lake said the government pays for 41 million outpatient lab tests a year. That鈥檚 61 per cent more than 10 years ago, and more than other provinces.
鈥淲e don鈥檛 view that as sustainable into the future.鈥�
Apart from VIHA鈥檚 move, an overall review of lab services is underway, because the government thinks the current system blocks any savings.
He said government has no ability to take advantage of technological change that makes for cheaper tests.
He plans to legislate changes that will make for better co-ordination and improved efficiency. Lake told reporters Wednesday that his ministry is talking about wheelchair fees with other health authorities as part of the move for consistency.
Overall, the continued pressure to bend the curve means 鈥渋nnovation, creativity and managing costs.鈥�
The Opposition has seized on 鈥淐hristy Clark鈥檚 wheelchair tax鈥� since independent MLA Vicki Huntington brought it to light last month.
New Democrat Leader Adrian Dix said the government gave approval to health authorities to charge for wheelchairs three years ago. But no one took them up on it, 鈥渂ecause it鈥檚 a lousy, unfair idea.鈥�
It was also an adroitly timed one.
The briefing note said they were going to give notice of the charge on April 1. But it didn鈥檛 come to light until after the election.
